5900-683 CHDV Project Reporting Template

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Overview

1. Instructions
2. Work Plan
3. Amendments
4. Financial Summary
5. Year 1
6. Year 2
7. Year 3
8. CHDV Priorities
9. Fleet Description
10. Infrastructure
11. Final Report
12. Data Dictionary

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Sheet 1: 1. Instructions

U. S. Environmental Protection Agency
Clean Heavy-Duty Vehicles (CHDV) Grant Program
Project Quarterly AND Final Reporting Template
Burden Statement for EPA Form 5900-683
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-NEW). Responses to this collection of information are voluntary (2 CFR 200 at 2 CFR 1500). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to range from 1.5 to 7.2 hours per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW,Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.
Instructions
Per grant agreement terms and conditions, this reporting template should be submitted 1) quarterly throughout the project period of performance and 2) a Final Report (120-days after) the completion of the grant period. Please work with relevant parties (i.e., transportation contractor, bus dealer, etc.) to ensure information submitted is accurate. Information that is submitted on quarterly reports should NOT be changed in future quarterly report submissions unless approved by EPA. Please only update information for the specific quarter in which this report is being submitted. The grant recipient only needs to fill out shaded cells highlighted blue with a diagonal pattern (///). Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Additionally, some fields will automatically hash out (///) in the event they are inapplicable based on previous descriptions. Please complete tabs in this workbook according to the instructions below; all fields are required, unless otherwise stated.
Excel Workbook Tab	Definition
1. Instructions	Basic instructions for all worksheets in this reporting workbook.
2. Work Plan	The tab should be completed within the first month of working with your project officer and reflects the approved work plan. Please complete shaded cells highlighted blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet; note for Table 1b, these responses will be autocompleted based on your entries on the Fleet Description tab (tab 9) and Infrastructure tab (10). For school district applicants, only the first row of Table 2 will be completed. Refer to the Data Dictionary tab 12 for additional guidance on each field.
3. Amendments	The Amendments tab should be used to update any changes in vehicle numbers, charger numbers, and/or funding amounts post-award. Please update this tab on an annual basis at the end of each year of project performance and at project closeout using the shade cells highlighted in blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet.
4. Financial Summary	Financial summary for the entire grant period of performance. Please complete shaded cells highlighted blue that contain grantee and original project budget information. Yellow cells on this worksheet will automatically feed from information in tabs 5-7 (Year 1-Year 3). If a modification to the grant is approved, please update the financial tabs accordingly.
5. Year 1	Financial summary for the first year of the project period. For each quarterly report, please complete all financial and narrative descriptive cells highlighted blue for each quarter the report is submitted. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Below the financial information, please ensure to complete the programmatic questions regarding the grant.
6. Year 2	Financial summary for the second year of the project period if grant period of performance is longer than one year. For each quarterly report, please complete all shaded financial and narrative descriptive cells highlighted blue for each quarter the report is submitted. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Below the financial information, please ensure to complete the programmatic questions regarding the grant.
7. Year 3	Financial summary for the third year of the project period if grant period of performance is longer than two years. For each quarterly report, please complete all shaded financial and narrative descriptive cells highlighted blue for each quarter the report is submitted. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Below the financial information, please ensure to complete the programmatic questions regarding the grant.
8. CHDV Priorities	The tab should be completed based upon environmental justice, community engagement, sustainability, workforce development, climate impact resiliency, and/or leveraging of additional external funds commitments defined in the proposed workplan. Please complete this tab QUARTERLY, if the proposed workplan committed to ANY environmental justice, community engagement, sustainability, workforce development, climate impact resiliency, and/or leveraging of additional external funds commitments as referred to in the evaluation metrics defined in the NOFO. During each quarterly reporting period of the project period of performance, please complete updates on these defined project commitments. The final report submission for the project should contain the end results of environmental justice, community engagement, sustainability, workforce development, climate impact resiliency, and/or leveraging of additional external funds commitments completed during the project period.
9. Fleet Description	The Fleet Description should detail all vehicles impacted under the project. The Fleet Description should be updated quarterly with all vehicle upgrades completed. Please fill out shaded cells highlighted blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. You do NOT need to make a separate worksheet for each school district. This Fleet Description is broken into two sections: 1) Current Vehicle Information and 2) New Vehicle Upgrade Information. The sheet has capacity for 100 vehicles. Please refer to the Fleet Description data definitions on tab 12 (Data Dictionary) for additional guidance on each field.
10. Infrastructure	The Infrastructure Description should detail all electric vehicle supply equipment (EVSE) and other eligible supporting infrastructure purchased under the project. The Infrastructure worksheet should be updated quarterly as EVSEs and other eligible supporting infrastructure are procured and installed. Please fill out shaded cells highlighted blue and add additional rows as needed to capture all units. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Please refer to the Infrastructure data definitions on Tab 12 (Data Dictionary) for data field definitions. Reminder: All Level 2 EVSEs must be ENERGY STAR certified. All EVSE and infrastructure must comply with Build America, Buy America (BABA) requirements.
11. Final Report	Final project details including actual emission and programmatic results. Please complete shaded cells highlighted blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet.
12. Data Dictionary	Please refer to the dictionary on this tab for support in completing the Fleet Description (tab 9).

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Sheet 2: 2. Work Plan

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Work Plan

Instructions

Please complete above Finacial Summary and Tables 1-4 below on this tab using information from your approved workplan. The grant recipient must fill out shaded cells highlighted blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet.

Grant Recipient

Grant Number

Project Period of Performance

[START DATE] - [END DATE]

Project Title

Table 1a. Project Summary and Approach

Does the project include school buses?

Does the project include non-school-bus zero-emission Class 6/7 vehicles?

If you intend to purchase hydrogen fuel-cell electric vehicles (FCEV), may we contact you about them?

Please use the space provided to add a short narrative description of the project summary and approach to cover anything not captured in Table 2. Work Plan. Language from the Project Summary and Approach section of the application may be used here.

Table 1b. Financial Summary

Federal Project Award Amount

$-

Estimated EPA Funds for Vehicles

$0.00

Estimated EPA Funds for EV Chargers

$0.00

Estimated EPA Funds for non-School-Bus Class 6/7 Vehicles

Estimated EPA Funds for AC Level 2 Chargers

Estimated EPA Funds for Electric School Buses

Estimated EPA Funds for DC Level 3 Chargers

Table 2. Work Plan

Please complete the following table of information. For school district applicants, only the first row will be completed. For state, other municipality, and nonprofit school transportation association applicants, please provide information for each school district that will be served by the new buses. Please refer to the School District data definitions on tab 12 (Data Dictionary) for additional guidance on each field.

School District Summary

Proposed Fleet + Chargers

School District Name

NCES #

State

County

City

Zip Code

Prioritized

Self-Certified as Prioritized

Non-Attainment Area

Proposed Number of Zero-Emission Vehicles

Proposed Number of AC Level 2 Charger

Proposed Number of DC Level 3 Charger

Total Number of Chargers

School District A

1234567

AZ

Maricopa

Phoenix

85308

Yes

Yes - Large SD with 80% Title I

Yes

20

10

5

15

0

0

0

0

0

0

0

0

0

0

0

0

non-School-Bus Grantee Summary

Proposed Fleet + Chargers

non-School-Bus Recipient Organization

N/A

State

County

City

Zip Code

N/A

N/A

Non-Attainment Area

Proposed Number of Zero-Emission Vehicles

Proposed Number of AC Level 2 Charger

Proposed Number of DC Level 3 Charger

Total Number of Chargers

0

0

0

0

0

0

0

0

0

0

0

0

Table 3. CHDV Priorities

A. Community Engagement

Does the workplan demonstrate actions and/or commitments to engage communities? If no, please jump to the next section, "Project Sustainability." If yes, please complete the rest of this section.

(Y or N or N/A)

1. How does the workplan demonstrate engagement with the communities identified above, especially local residents, to ensure their meaningful participation with respect to the design, planning, and performance of the project?

B. Project Sustainability

Does the workplan demonstrate actions and/or commitments to promote sustainable project results and benefits? If no, please jump to the next section, "Workforce Development." If yes, please complete the rest of this section.

(Y or N or N/A)

1. How does the workplan demonstrate that project results and benefits will be sustainable and that the applicant and project partners have the ability to promote and continue efforts to reduce emissions from vehicles after EPA funding for the project has ended?

C. Workforce Development

Does the workplan demonstrate actions and/or commitments to promote workforce development? If no, please jump to the next section, "Project Resilience to Climate Impacts." If yes, please complete the rest of this section.

(Y or N or N/A)

1. How does the workplan demonstrate a plan to prepare the workforce for the project?

D. Project Resilience to Climate Impacts

Does the workplan demonstrate actions and/or commitments to promote project resilience to climate impacts? If no, please jump to the next section, "Leveraging of Additional External Funds". If yes, please complete the rest of this section.

1. How does the workplan demonstrate planning or action taken towards building project resilience and reducing vulnerabilities to climate impacts?

E. Leveraging of Additional External Funds

Does the workplan demonstrate that the recipient has leveraged or plans to leverage additional external funds in order to support proposed project activities? If no, please jump to the next table, "Timeline and Milestones". If yes, please complete the rest of this section.

1. How does the workplan demonstrate that the recipient has leveraged or plans to leverage additional external funds in order to support proposed project activities, as well as how these funds will be used to contribute to the performance and success of the project?

Table 4. Timeline and Milestones

Please use the rows below to indicate key project milestones and activities, the timeline for each, and the responsible party for each milestone and activity. Timeline can be represented either as the expected month(s) each activity/milestone will take place (ex., September 2024, September 2024 - December 2024, etc.), or, if applicable, can be represented with descriptors such as "continuous," "ongoing," or otherwise described in relation to other activities and milestones (ex., 1 month after activity X). Note: Additional rows may be added as needed.

Timeline

Milestone/Activity

Responsible Party

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Sheet 3: 3. Amendments

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Amendments

Instructions

Please use this tab to indicate any changes in bus numbers, charger numbers, and/or funding amounts post-award. Fill out this tab at the end of each year of project performance.

Number of Amendments By Year

Change in Funding Amount by Year

Were there any changes to vehicle numbers, charger numbers, and/or funding amounts in Year 1 of the project period of performance? If yes, please indicate the change(s) using the table below.

(Y or N)

Project Year 1

0

$-

Were there any changes to vehicle numbers, charger numbers, and/or funding amounts in Year 2 of the project period of performance? If yes, please indicate the change(s) using the table below.

(Y or N)

Project Year 2

0

$-

(If applicable based on project period length) Were there any changes to vehicle numbers, charger numbers, and/or funding amounts in Year 3 of the project period of performance? If yes, please indicate the change(s) using the table below.

(Y or N)

Project Year 3

0

$-

Table 5. Post-Award Amendments

Update Year

Type of Amendment

Grantee Name

NCES ID (If applicable)

Original Vehicle or Eligible Infrastructure Component Type

Updated Vehicle or Eligible Infrastructure Component Type

Original Quantity of Vehicle or Eligible Infrastructure Component

Updated Quantity of Vehicle or Eligible Infrastructure Type

If 'Other Changes' selected as Type of Amendment, please describe here

Original Funding Request Amount

Updated Funding Request Amount

Change in Funding Amount

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

(Select Year)

(Select Amendment Type)

$-

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Sheet 4: 4. Financial Summary

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Financial Summary - Project Lifetime

Grant Recipient

EPA Project Award Amount

$-

Grant Number

Total Non-CHDV Project Costs

$-

Project Period of Performance

Total Applicant Funds

$-

Project Title

Total Additional Leveraged Funds

$-

EPA Funds Expended to Date

$-

EPA Funds Remaining

$-

Table 6. Summary Rate of Expenditure

Record project budget funds ONLY from approved final workplan. All other numbers will reflect automatically from subsequent tabs.

Financial Summary

Project Budget

Total Expenses to Date

Remaining Balance

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

Personnel

$-

$-

$-

$-

$-

$-

$-

$-

$-

Fringe Benefits

$-

$-

$-

$-

$-

$-

$-

$-

$-

Travel

$-

$-

$-

$-

$-

$-

$-

$-

$-

Equipment

$-

$-

$-

$-

$-

$-

$-

$-

$-

Supplies

$-

$-

$-

$-

$-

$-

$-

$-

$-

Contractual

$-

$-

$-

$-

$-

$-

$-

$-

$-

Other

$-

$-

$-

$-

$-

$-

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Table 7. Annual Rate of Expenditure

No Entry Needed - ALL numbers will reflect automatically from subsequent tabs.

Financial Summary

Year 1

Year 2

Year 3 (if applicable)

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

Personnel

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Fringe Benefits

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Travel

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Equipment

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Supplies

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Contractual

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Other

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

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Sheet 5: 5. Year 1

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Financial and Narrative Summary - Year 1

Grant Recipient

Total EPA Funds Expended: Year 1

$-

Grant Number

Reporting Cadence

Quarterly

Project Title

Project Reporting Period

Table 10. Year 1 Annual Rate of Expenditure

Record and update project expenses at each interval according to the reporting cadence determined by your Project Officer. Previous fields should remain and edits should be made to the whenever interannual reports are submitted. Note the table will update based upon the Reporting Cadence field, selected above.

Quarter 1

Quarter 2

Quarter 3

Quarter 4

Enter Dates For this Reporting Period

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

Personnel

$-

$-

$-

$-

Fringe Benefits

$-

$-

$-

$-

Travel

$-

$-

$-

$-

Equipment

$-

$-

$-

$-

Supplies

$-

$-

$-

$-

Contractual

$-

$-

$-

$-

Other

$-

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Table 11. Project Updates - Narrative Responses

Record and update project updates below.

Please paste the planned activities, outputs, and outcome from the submitted workplan information. Provide updates and if any changes occurred, please provide that information accordingly. In the 'Progress to Date' column, please use the dropdown to indicate if the activity is 1) Not yet started, 2) In progress, or 3) Completed.

Activities

Anticipated Outputs

Anticipated Outcomes

Progress to Date

Progress Notes

Q1

Q2

Q3

Q4

Write below, as appropriate.

Please provide programmatic and narrative financial updates on the project. As quarterly reports are submitted, indicate updates or changes for each quarter. For each quarter, please indicate if there was a change from the previous quarter. If yes, please provide an explanation in the subsequent cell.

Question

Quarter 1 Update

Quarter 2 Update

Quarter 3 Update

Quarter 4 Update

1. Provide a comparison of actual accomplishments to the objectives established for the reporting period.

2. If anticipated outputs/outcomes and/or timelines/milestones are not met, why not? Did you encounter any problems during the reporting period which may interfere with meeting project objectives?

3. If any additional external leveraged funds are reported for this Reporting Period in Table 5 above, identify the source of the funds.

4. Have there been any major personnel changes during this reporting period?

5. Did any public relations events regarding this grant take place during the reporting period?

6. Are you using websites or other tools used to relay information about this grant to the public?

7. What project activities are planned for the next reporting period?

8. Was any program income generated during the reporting period? Identify amount of program income, how it was generated, and how the program income was/will be used.

9. Have any vehicles or activities changed from those included in the final workplan?

10. Do you have any other comments or feedback?

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Sheet 6: 6. Year 2

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Financial and Narrative Summary - Year 2

Grant Recipient

Total EPA Funds Expended: Year 1

$-

Grant Number

Reporting Cadence

Quarterly

Project Title

Project Reporting Period

Table 10. Year 1 Annual Rate of Expenditure

Record and update project expenses quarterly. Previous fields should remain and edits should be made to the quarterly report being submitted. Note the table will update based upon the Reporting Cadence field, selected above.

Quarter 1

Quarter 2

Quarter 3

Quarter 4

Enter Dates For this Reporting Period

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

Personnel

$-

$-

$-

$-

Fringe Benefits

$-

$-

$-

$-

Travel

$-

$-

$-

$-

Equipment

$-

$-

$-

$-

Supplies

$-

$-

$-

$-

Contractual

$-

$-

$-

$-

Other

$-

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Table 11. Project Updates - Narrative Responses

Record and update project updates below.

Please paste the planned activities, outputs, and outcome from the submitted workplan information. Provide updates and if any changes occurred, please provide that information accordingly. In the 'Progress to Date' column, please use the dropdown to indicate if the activity is 1) Not yet started, 2) In progress, or 3) Completed.

Activities

Anticipated Outputs

Anticipated Outcomes

Progress to Date

Progress Notes

Q1

Q2

Q3

Q4

Write below, as appropriate.

Please provide programmatic and narrative financial updates on the project. As quarterly reports are submitted, indicate updates or changes for each quarter. For each quarter, please indicate if there was a change from the previous quarter. If yes, please provide an explanation in the subsequent cell.

Question

Quarter 1 Update

Quarter 2 Update

Quarter 3 Update

Quarter 4 Update

1. Provide a comparison of actual accomplishments to the objectives established for the reporting period.

2. If anticipated outputs/outcomes and/or timelines/milestones are not met, why not? Did you encounter any problems during the reporting period which may interfere with meeting project objectives?

3. If any additional external leveraged funds are reported for this Reporting Period in Table 5 above, identify the source of the funds.

4. Have there been any major personnel changes during this reporting period?

5. Did any public relations events regarding this grant take place during the reporting period?

6. Are you using websites or other tools used to relay information about this grant to the public?

7. What project activities are planned for the next reporting period?

8. Was any program income generated during the reporting period? Identify amount of program income, how it was generated, and how the program income was/will be used.

9. Have any vehicles or activities changed from those included in the final workplan?

10. Do you have any other comments or feedback?

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Sheet 7: 7. Year 3

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Financial and Narrative Summary - Year 3

Grant Recipient

Total EPA Funds Expended: Year 3

$-

Grant Number

Reporting Cadence

Quarterly

Project Title

Project Reporting Period

Table 10. Year 3 Annual Rate of Expenditure

Record and update project expenses quarterly. Previous fields should remain and edits should be made to the quarterly report being submitted. Note the table will update based upon the Reporting Cadence field, selected above.

Quarter 1

Quarter 2

Quarter 3

Quarter 4

Enter Dates For this Reporting Period

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

EPA Funds

Mandatory Cost Share

Additional Leveraged Funds

Total Project Cost

Personnel

$-

$-

$-

$-

Fringe Benefits

$-

$-

$-

$-

Travel

$-

$-

$-

$-

Equipment

$-

$-

$-

$-

Supplies

$-

$-

$-

$-

Contractual

$-

$-

$-

$-

Other

$-

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Table 11. Project Updates - Narrative Responses

Record and update project updates below.

Please paste the planned activities, outputs, and outcome from the submitted workplan information. Provide updates and if any changes occurred, please provide that information accordingly. In the 'Progress to Date' column, please use the dropdown to indicate if the activity is 1) Not yet started, 2) In progress, or 3) Completed.

Activities

Anticipated Outputs

Anticipated Outcomes

Progress to Date

Progress Notes

Q1

Q2

Q3

Q4

Write below, as appropriate.

Please provide programmatic and narrative financial updates on the project. As quarterly reports are submitted, indicate updates or changes for each quarter. For each quarter, please indicate if there was a change from the previous quarter. If yes, please provide an explanation in the subsequent cell.

Question

Quarter 1 Update

Quarter 2 Update

Quarter 3 Update

Quarter 4 Update

1. Provide a comparison of actual accomplishments to the objectives established for the reporting period.

2. If anticipated outputs/outcomes and/or timelines/milestones are not met, why not? Did you encounter any problems during the reporting period which may interfere with meeting project objectives?

3. If any additional external leveraged funds are reported for this Reporting Period in Table 5 above, identify the source of the funds.

4. Have there been any major personnel changes during this reporting period?

5. Did any public relations events regarding this grant take place during the reporting period?

6. Are you using websites or other tools used to relay information about this grant to the public?

7. What project activities are planned for the next reporting period?

8. Was any program income generated during the reporting period? Identify amount of program income, how it was generated, and how the program income was/will be used.

9. Have any vehicles or activities changed from those included in the final workplan?

10. Do you have any other comments or feedback?

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Sheet 8: 8. CHDV Priorities

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

CHDV Priorities

Grant Recipient

Grant Number

Project Title

Instructions

Please complete this tab if your organization committed to ANY environmental justice, community engagement, sustainability, workforce development, climate impact resiliency, or leveraging of additional external funds actions or commitments in your application, as referred to in the evaluation metrics defined in section V.A. Evaluation Criteria in the NOFO. Only cells shaded in blue need to be filled out; cells shaded in yellow will automatically populate based on information entered in earlier tabs. If planned activities or commitments changed between the submitted application and approved workplan, please indicate on the first question below. Please use the drop downs for columns to indicate any updates that occurred during the reporting period indicating continued progress towards commitments. At the end of each of the sections below, there is a cell to provide additional narrative responses, as appropriate. Please take care to ensure all questions are answered; the final question is on row 127 of this sheet.

Did any planned activities or commitments change between the submitted application and the approved workplan?

(Y or N or N/A)

If no, please jump to the next section, "Environmental Justice and Disadvantaged Communities." If yes, please provide context and details to the approved changes (example: the number of electric vehicles was reduced due to partial funding).

Table 14. Environmental Justice and Disadvantaged Communities

1. Did the workplan demonstrate that the project will benefit communities that meet one or more of the criteria for prioritization listed in the NOFO in Section I.B?

(Y or N or N/A)

2. Did any beneficiaries from the workplan decide to no longer participate in the project? If yes, please use the rows below to indicate which beneficiaries withdrew their participation from the project, and if applicable, please note what beneficiary was chosen as a replacement. Note: Please add additional rows as needed.

(Y or N or N/A)

Withdrawn Beneficiary

NCES ID (if applicable)

Prioritization Status on Prioritized District List or Self-Certified

Date of Withdrawal

Brief Description of Reason for Withdrawal

Replacement Beneficiary (use "N/A" if beneficiary not replaced)

NCES ID (if applicable)

(Y or N or N/A)

Select Quarter

(Y or N or N/A)

Select Quarter

(Y or N or N/A)

Select Quarter

(Y or N or N/A)

Select Quarter

(Y or N or N/A)

Select Quarter

(Y or N or N/A)

Select Quarter

Table 15. Community Engagement

Did the workplan demonstrate actions and/or commitments to engage communities? If no, please jump to the next section, "Project Sustainability". If yes, please complete the rest of this section.

(Y or N or N/A)

1. How did the workplan demonstrate engagement with the communities identified above, especially local residents, to ensure their meaningful participation with respect to the design, planning, and performance of the project?

Policy/Process to Engage Communities and Point of Contact

Application

Status Update

Quarter Completed

1. Did the workplan for this project demonstrate that the recipient and/or project partner(s) has an existing clear point of contact in a public platform (e.g., newsletter, website) for community issues and complaints (specific to air quality or broader) and a publicly documented policy or process to engage communities and get their input on operations and projects that impact air quality? The process could be a meeting in the past year and/or a policy or process to have a meeting or otherwise get input (e.g., a standing citizens advisory committee). Please include any narrative details in question 2.

(Y or N or N/A)

1.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to completing one before the end of the project period?

(Y or N or N/A)

1.b. To date, has the recipient and/or project partner(s) completed this commitment?

Select Status

Select Quarter

2. Please provide any additional details and/or a status update to be provided for this category, including but not limited to the URL(s) where the public can find the clear point of contact and policy or process; a description of the point of contact and policy or process; and any other relevant information. Please use the drop downs under 'Please Select One' to indicate which year the update was completed. Note: Do not delete data from prior quarterly reports. If providing updates for multiple quarters in one year, please indicate all updates in the same cell.

Please Select One

Please Select One

Please Select One

Table 16. Project Sustainability

Did the workplan demonstrate actions and/or commitments to promote sustainable project results and benefits? If no, please jump to the next section, "Workforce Development". If yes, please complete the rest of this section.

(Y or N or N/A)

1. How did the workplan demonstrate that project results and benefits will be sustainable and that the applicant and project partners have the ability to promote and continue efforts to reduce emissions from vehicles after EPA funding for the project has ended?

A. Zero-Emission Projects For non-ZE projects, skip to part B.

Application

Status Update

Quarter Completed

A1. Did the workplan for this project demonstrate coordination and/or consultation with utilities on the feasibility of the project? This could include, but is not limited to, discussion with utilities on project charging needs, project upgrade needs, project costs, rates for future service, and/or the timeframe for necessary upgrades. Please include any narrative details in question A2.

(Y or N or N/A)

A1.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to such coordination before the end of the project period?

(Y or N or N/A)

A1.b. To date, has the recipient and/or project partner(s) completed this commitment?

Select Status

Select Quarter

A2. Please provide additional details and any relevant status updates for this section, including but not limited to describing the extent of coordination with utilities, noting the timing and frequency of discussions with utilities, and any project decisions impacted by these discussions. Please use the drop downs under 'Please Select One' to indicate which year the update was completed. Note: Do not delete data from prior quarterly reports. If providing updates for multiple quarters in one year, please indicate all updates in the same cell.

Please Select One

Please Select One

Please Select One

Table 17. Workforce Development

Did the workplan demonstrate actions and/or commitments to promote workforce development? If no, please jump to the next section, "Project Resilience to Climate Impacts". If yes, please complete the rest of this section.

(Y or N or N/A)

1. How did the workplan demonstrate a plan to prepare the workforce for the project?

Application

Status Update

Quarter Completed

2. Did the workplan for this project demonstrate that current drivers, mechanics, electricians, and other essential personnel have received training to safely operate and maintain the new vehicles and infrastructure? This could include the establishment of workforce training programs for zero emission vehicles and charging infrastructure. Please include any narrative details in question 6.

(Y or N or N/A)

2.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to ensuring current drivers, mechanics, electricians, and other essential personnel receive training to safely operate and maintain the new vehicles and infrastructure before the end of the project period?

(Y or N or N/A)

2.b. To date, has the recipient and/or project partner(s) completed this commitment?

Select Status

Select Quarter

3. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have clarified protections to ensure existing workers are not replaced or displaced because of new technologies? Please include any narrative details in question 6.

(Y or N or N/A)

3.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to clarifying protections to ensure existing workers are not replaced for displaced because of new technologies before the end of the project period?

(Y or N or N/A)

3.b. To date, has the recipient and/or project partner(s) completed this commitment?

Select Status

Select Quarter

4. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have increased the availability of domestic manufacturing and workforce for zero-emission vehicles, engines, and other key components (e.g., batteries)? Please include any narrative details in question 6.

(Y or N or N/A)

4.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to increasing the availability of domestic manufacturing and workforce for zero- and near-zero emission vehicles, engines, and other key components (e.g., batteries) before the end of the project period?

(Y or N or N/A)

4.b. To date, has the recipient and/or project partner(s) completed this commitment?

Select Status

Select Quarter

5. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have other measures and/or policies in place to promote workforce development? If yes, please describe the other measures and/or policies in more detail below. Please include any narrative details in question 6.

(Y or N or N/A)

5.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit establishing measures and/or policies to promote workforce development before the end of the project period?

(Y or N or N/A)

5.b. To date, has the recipient and/or project partner(s) completed this commitment?

Select Status

Select Quarter

6. Please provide additional details and any relevant status updates for this section, including but not limited to details on training programs, protections for existing workers, measures taken to increase the availability of domestic manufacturing and workforce, and/or descriptions of any additional policies and measures to promote workforce development, as well as any changes made to these throughout the project period. Please use the drop downs under 'Please Select One' to indicate which year the update was completed. Note: Do not delete data from prior quarterly reports. If providing updates for multiple quarters in one year, please indicate all updates in the same cell.

Please Select One

Please Select One

Please Select One

Table 18. Project Resilience to Climate Impacts

Did the workplan demonstrate actions and/or commitments to promote project resilience to climate impacts? If no, please jump to the next section, "Leveraging of Additional External Funds". If yes, please complete the rest of this section.

0

1. How did the workplan demonstrate planning or action taken towards building project resilience and reducing vulnerabilities to climate impacts?

Application

Status Update

Quarter Completed

2. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have assessed and implemented climate change adaptation considerations to help ensure that the project achieves its expected outcomes even as the climate changes? This could include assessing project vulnerability to local climate impacts when making siting decision and operational plans, ensuring fleets and equipment are protected from climate change impacts, and/or protecting infrastructure from storm damage. Please include any narrative details in question 4.

(Y or N or N/A)

2.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to assessing and implementing climate change adaptation considerations before the end of the project period?

(Y or N or N/A)

2.b. To date, has the recipient and/or project partner(s) completed this commitment?

Select Status

Select Quarter

3. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have other measures and/or policies in place to promote project resilience to climate impacts? If yes, please describe the other measures and/or policies in more detail below. Please include any narrative details in question 4.

(Y or N or N/A)

3.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit establishing measures and/or policies to promote project resilience to climate impacts before the end of the project period?

(Y or N or N/A)

3.b. To date, has the recipient and/or project partner(s) completed this commitment?

Select Status

Select Quarter

4. Please provide additional details and any relevant status updates for this section, including but not limited to details on climate impact assessments, descriptions of project decisions impacted by these assessments, and/or descriptions of any additional policies and measures to promote project resilience to climate impacts, as well as any changes made to these throughout the project period. Please use the drop downs under 'Please Select One' to indicate which year the update was completed. Note: Do not delete data from prior quarterly reports. If providing updates for multiple quarters in one year, please indicate all updates in the same cell.

Please Select One

Please Select One

Please Select One

Table 19. Leveraging of Additional External Funds

Did the workplan demonstrate that the recipient has leveraged or plans to leverage additional external funds in order to support proposed project activities? If no, please jump to the next section, "Other". If yes, please complete the rest of this section.

0

1. How did the workplan demonstrate that the recipient has leveraged or plans to leverage additional external funds in order to support proposed project activities, as well as how these funds will be used to contribute to the performance and success of the project?

2. Please provide updates on proposed or secured additional external funds using the rows below. This should include additional external leveraged funds, but should not include applicant funds. Refer to the following definitions when selecting Status: "Not Yet Started:" Funding is proposed but the application process has not yet begun "In Progress:" The funding application or selection process is underway, but funds have not been awarded "Awarded:" Funding has been officially awarded "Not Awarded:" Funding that had been applied for was not awarded Note: Please add additional rows as needed.

Source Name

Amount ($)

Status

Quarter Awarded

Please Select One

Select Quarter

Please Select One

Select Quarter

Please Select One

Select Quarter

Please Select One

Select Quarter

Please Select One

Select Quarter

Please Select One

Select Quarter

Please Select One

Select Quarter

Please Select One

Select Quarter

Please Select One

Select Quarter

Please Select One

Select Quarter

3. Are there any updates to be provided or additional information for any proposed or secured additional external funds? If yes, please provide additional details and a status update below, including a description of how any secured funds are being used to support proposed project activities and how they are contributing to the performance and success of the project. If any proposed funding was not awarded, use the space provided to indicate your plans to make up for these funds. Please use the drop downs under 'Please Select One' to indicate which year the update was completed. Note: Do not delete data from prior quarterly reports. If providing updates for multiple quarters in one year, please indicate all updates in the same cell.

(Y or N or N/A)

Please Select One

Please Select One

Please Select One

OTHER: Please provide any additional details or comments regarding environmental justice, community engagement, sustainability, workforce development, resiliency to climate impacts, or leveraged additional external funds of the project.

---

Sheet 9: 9. Fleet Description

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Fleet Description

Grant Recipient

Grant Number

Project Title

Instructions

The Fleet Description should detail all vehicles impacted under the project. The Fleet Description should be updated quarterly with all vehicle upgrades completed. Please fill out all shaded cells highlighted blue with a diagonal pattern (///). This Fleet Description is broken into two sections: 1) Current Vehicle Information and 2) New Vehicle Upgrade Information. The sheet has capacity for 100 vehicles. Please refer to the Fleet Description data definitions on tab 12 (Data Dictionary) for additional guidance on each field.

Table 20. CURRENT VEHICLE INFORMATION

Table 21. NEW REPLACEMENT VEHICLE INFORMATION

20a. Basic Fleet Information

20b. Current Vehicle Information

20c. Current Vehicle Activity Information

20d. Vehicle Disposition Process

20e. Current Vehicle Place(s) of Performance

21a. Upgrade Vehicle Information

21b. Upgrade Cost

21c. New Vehicle Activity Information

21d. New Vehicle Battery Information (for Battery Electric Vehicles Only)

21e. New Vehicle Fuel Cell Information (for Fuel Cell EVs Only)

21f. Warranty Information

20g. New Vehicle Place(s) of Performance

21h. Optional Participation in Future of Transportation Research

Primary Place of Performance

Secondary Place of Performance (if applicable)

Additional Location Details (if applicable)

Primary Place of Performance

Secondary Place of Performance (if applicable)

Additional Location Details (if applicable)

Vehicle

Group Name

Current Fleet Owner

Publicly or Privately Owned (select from dropdown)

Vehicle Type (select from dropdown)

Vehicle Class (select from dropdown)

Vehicle Vocation (select from dropdown)

Vehicle Group Sector (select from dropdown)

Vehicle Identification Number (VIN)

Vehicle Manufacturer

Vehicle Model

Baseline Vehicle Model Year

Baseline Engine Fuel Type (select from dropdown)

Engine Family Name (if unregulated, then NA)

GVWR

Annual Miles Traveled (miles per vehicle)

Annual Idling Hours (hours per engine)

Current Odometer (in miles)

Annual Amount of Fuel Used (gallons/year per engine)

Remaining Life of Baseline Engine/Vehicle

Vehicle Disposition/Replacement Process

If sold or donated, provide the state in which the vehicle is expected to primarily operate (if known, select from dropdown)

If sold or donated, provide the county in which the vehicle is expected to primarily operate (if known, select from dropdown)

School District Name (if applicable)

NCES ID (if applicable)

State (select from dropdown)

County (select from dropdown)

Percentage of Time operated in County

Place of Performance: City

Zip Code(s)

School District Name (if applicable)_2

NCES ID (if applicable)_2

State_2

County_3

Percentage of Time operated in County_2

Place of Performance: City_3

Zip Code(s)_2

Additional Counties where Vehicle Operates

% of time operated in each Additional County

Year of Upgrade Action

New Vehicle Fleet Owner

New Vehicle Class (select from dropdown)

VIN for New Vehicle(s)

New Vehicle Manufacturer

New Vehicle Model

New Vehicle Model Year

New Engine Family Name

New Vehicle Fuel Type

New Vehicle GVWR

Upgrade Cost per Vehicle

Total Federal Funds Expended Per Vehicle ($ of Total Cost per Unit)

New Vehicle Annual Miles Traveled (miles per vehicle)

New Vehicle Equipped with Auxiliary Heater? (Yes/No)

Auxiliary Heater Type (if not applicable, then NA)

Capable of Bidirectional Charging? (Yes/No/N/A)

Manufacturer of Battery Pack

Number of Battery Packs

Battery Capacity per Battery Pack (kWh)

Vehicle Total Battery Capacity (kWh)

Rated Charging Power (kW)

Estimated Range in Miles

Manufacturer of Fuel Cell System (if known)

Fuel Cell Stack Capacity (kW)

Hydrogen Fuel Tank Capacity (kg)

Is the Battery or Fuel Cell System Warranty Included? (Yes/No)

Number of Years Covered by Battery or Fuel Cell System Warranty

Number of Miles Covered by Battery or Fuel Cell System Warranty

Total kWh of Battery or Fuel Cell System Discharge Covered by Warranty

Powertrain Warranty Included? (Yes/No)

Number of Years Covered by Powertrain Warranty

Number of Miles Covered by Powertrain Warranty

School District Name (if applicable)_3

NCES ID (if applicable)_3

State (select from dropdown)_3

County (select from dropdown)2

Percentage of Time operated in County_2 (Enter value between 0-1)

Place of Performance: City_2

Zip Code(s)_3

School District Name (if applicable)_4

NCES ID (if applicable)_4

State (select from dropdown)_4

County (select from dropdown)_4

Percentage of Time operated in County_3 (enter value 0-1)

Place of Performance: City_4

Zip Code(s)_4

Additional Counties where Vehicle Operates_2

% of time operated in each Additional County_2

Is the vehicle/equipment equipped with Telematics? (Yes/No/Not Sure)

EPA or its partners may contact me about participating in research opportunities to provide vehicle or EVSE data that could inform future transportation work. (Yes/No)

If Yes, Telematics Primary Point of Contact (name and email)

Example Vehicle

ESBs for District A

Sarah Smith

Publicly Owned

Short Haul - Single Unit

Class 6

Drayage

Port

12345678910ABCDEFG

Manufacturer Name

Model Name or #

1995

Diesel

N/A

10150

140000

12000

1500

6000

3

Approved Scrappage Waiver

CA

Alameda County

Warren 01

123456

SC

Warren

100%

Springhill

123456

Warren 01

123456

SC

Warren

100%

Springhill

123456

2025

Walton School District

Class 6

1234567890ABCDE

Manufacturer Name

Model Name or #

2023

ABC

Battery Electric

12000

$375,000.00

$325,000.00

12000

Yes

Yes

Battery & Co.

6

90

540

360

200

Fuel Cell Co.

140

800

Yes

8

160,000

200,000

Yes

4

100,000

Warren 01

123456

SC

Warren

100%

Springhill

123456

Warren 01

123456

SC

Warren

100%

Springhill

123456

Pima County, AZ; La Paz County, AZ

5% in Pima; 5% in La Paz

Yes

Yes

Sarah Smith, [email protected]

Vehicle 1

Vehicle 2

Vehicle 3

Vehicle 4

Vehicle 5

Vehicle 6

Vehicle 7

Vehicle 8

Vehicle 9

Vehicle 10

Vehicle 11

Vehicle 12

Vehicle 13

Vehicle 14

Vehicle 15

Vehicle 16

Vehicle 17

Vehicle 18

Vehicle 19

Vehicle 20

Vehicle 21

Vehicle 22

Vehicle 23

Vehicle 24

Vehicle 25

Vehicle 26

Vehicle 27

Vehicle 28

Vehicle 29

Vehicle 30

Vehicle 31

Vehicle 32

Vehicle 33

Vehicle 34

Vehicle 35

Vehicle 36

Vehicle 37

Vehicle 38

Vehicle 39

Vehicle 40

Vehicle 41

Vehicle 42

Vehicle 43

Vehicle 44

Vehicle 45

Vehicle 46

Vehicle 47

Vehicle 48

Vehicle 49

Vehicle 50

Vehicle 51

Vehicle 52

Vehicle 53

Vehicle 54

Vehicle 55

Vehicle 56

Vehicle 57

Vehicle 58

Vehicle 59

Vehicle 60

Vehicle 61

Vehicle 62

Vehicle 63

Vehicle 64

Vehicle 65

Vehicle 66

Vehicle 67

Vehicle 68

Vehicle 69

Vehicle 70

Vehicle 71

Vehicle 72

Vehicle 73

Vehicle 74

Vehicle 75

Vehicle 76

Vehicle 77

Vehicle 78

Vehicle 79

Vehicle 80

Vehicle 81

Vehicle 82

Vehicle 83

Vehicle 84

Vehicle 85

Vehicle 86

Vehicle 87

Vehicle 88

Vehicle 89

Vehicle 90

Vehicle 91

Vehicle 92

Vehicle 93

Vehicle 94

Vehicle 95

Vehicle 96

Vehicle 97

Vehicle 98

Vehicle 99

Vehicle 100

---

Sheet 10: 10. Infrastructure

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Infrastructure Description

Instructions

Below are three tables (20-22). Please complete all three. The EVSE Equipment Information (Table 21) should detail all electric vehicle supply equipment (EVSE) and supporting infrastructure purchased under the project. Table 22 focuses on on-site power generation systems and Table 23 on battery storage systems. For school district applicants the infrastructure needs to be listed by school district and/or city. That is, if School District A and School District B are procuring the same EVSE, the EVSE will appear as two separate EVSE Groups. Similarly, for large school districts, if EVSE are being installed in two different locations, the EVSE needs to appear as two separate EVSE Groups. The EV Infrastructure worksheet should be updated quarterly as EVSEs and supporting infrastructure are procured and installed. Please fill out all shaded cells highlighted blue with a diagonal pattern (///); note, additional rows may be added as needed to capture all equipment. Please refer to the EV Infrastructure data definitions on Tab 12 (Data Dictionary) for data field definitions. Reminder: All Level 2 EVSEs must be ENERGY STAR certified. All EVSE, on-site power generation systems, and battery energy storage systems (BESS) must comply with Build America, Buy America (BABA) requirements. See below for more information on BABA.

Build America, Buy America (BABA) requirements

On November 15, 2021, the Infrastructure Investment and Jobs Act ("IIJA"), Pub. L. No. 117-58, which includes the Build America, Buy America Act (BABA), Public Law 117-58, §§ 70901-52, was signed into law. BABA requires that on or after May 14, 2022, all of the iron, steel, manufactured products, and construction materials used in infrastructure project are produced in the United States. If award recipient will be installing, upgrading, or replacing “infrastructure,” then BABA requirements apply to the infrastructure project, regardless of whether or not the infrastructure project was the primary basis for the award. Additionally, BABA requirements apply even if the award recipient will be using another source of funding, whether in part or wholly, for the infrastructure project. For more information, please visit https://www.epa.gov/cwsrf/build-america-buy-america-baba.

Table 22: Electric Vehicle Service Equipment Information

Table 22a. EVSE Information Overview

Table 22b. Location of EV Infrastructure

Table 22c. Owners & Anticipated Users of EVSE

Table 22d. Charging Management Service

Table 22e. Infrastructure Installation Information & BABA Compliance

Table 22f. EVSE Cost Summary

Table 22g. Optional Participation in the Future of Transportation Research

Type of Charger

If Level 2, is it ENERGY STAR certified

EVSE Manufacturer

EVSE Model

EVSE Manufacture Year

Is the EVSE BABA Compliant?

EVSE Maximum Output Power (kW)

Number of Plugs on EVSE

Is the EVSE Capable of Bidirectional Charging?

Will the Vehicle and EVSE be Used for Vehicle to Grid (V2G)?

Number of EVSE Units

EVSE Equipment Cost only Per Unit

Total EPA Funds Expended Per EVSE Unit

Total EPA Funds Expended for EVSE

Date of EVSE Manufacture (mm/dd/yyyy)

Date of EVSE Installation (mm/dd/yyyy)

Date EVSE Operational (mm/dd/yyyy)

State (Select from dropdown)

County (Select from dropdown)

City

Zip Code

Street Address

Who owns the charger?

Anticipated User(s) of the Charger

If serving school districts, does the EVSE serve multiple school districts within this project?

Name of the School District(s) the EVSE will serve (if applicable; use a colon between school districts)

NCES ID of School District that the EVSE will serve (if applicable; use a colon between school districts)

Name of Charging Management Service Provider (if not applicable, enter "N/A")

Does the Infrastructure Equipment Cost Include Charging Management Service? (Yes/No)

If Charging Management Service not included in cost, but is acquired, what is the cost and frequency of charges?

Total Funds Expended Installation Cost

Total EPA Funds Expended Installation Cost

Does the Infrastructure Equipment Cost Include Installation?

Description of Installation Work

Installation Work Performed By

Installation was conducted by an individual who meets the infrastructure electrician requirements as outlined in the program guidance?

Is waiver being used to fulfill BABA compliance for the Infrastructure Project

Total EPA Funds Expended on EVSE Equipment and Installation

Total Funds Expended on EVSE Equipment and Installation

EPA or its partners may contact me about participating in research opportunities to provide EVSE data that could inform future transportation work. (Yes/No)

If Yes, Telematics Primary Point of contact (name and email)

Example EV Infrastructure

Level 2

Yes

Manufacturer Name

Model Name

2023

Yes

24

2

No

No

2

$16,000.00

$12,000.00

$24,000.00

5/27/2024

6/28/2024

8/28/2024

VA

Arlington County

Alexandria

22305

400 1st Street

Walton School District

Electric school buses serving Walton School District

Yes

Walton School District: Franklin School District

1234567: 7654321

Charge Manage & Co.

Yes

$250 per charger per month

$12,000

$7,000

No

Upgrades to the electrical panel, wiring, and installation for two DCFC

XYZ Electric Co.

Yes - Certification from EVITP

No - Infrastructure meets all BABA requirements

$31,000.00

$44,000.00

Yes

Sarah Smith, [email protected]

EVSE Group 1

$-

EVSE Group 2

$-

EVSE Group 3

$-

EVSE Group 4

$-

EVSE Group 5

$-

EVSE Group 6

$-

EVSE Group 7

$-

EVSE Group 8

$-

EVSE Group 9

$-

EVSE Group 10

$-

EVSE Group 11

$-

EVSE Group 12

$-

EVSE Group 13

$-

EVSE Group 14

$-

EVSE Group 15

$-

EVSE Group 16

$-

EVSE Group 17

$-

EVSE Group 18

$-

EVSE Group 19

$-

EVSE Group 20

$-

EVSE Group 21

$-

EVSE Group 22

$-

EVSE Group 23

$-

EVSE Group 24

$-

EVSE Group 25

$-

EVSE Group 26

$-

EVSE Group 27

$-

EVSE Group 28

$-

EVSE Group 29

$-

EVSE Group 30

$-

Table 23. On-Site Power Generation Equipment Information

Note: If the on-site power generation includes an energy storage system, information for such system needs to be documented in the table below this one.

Table 23a. On-Site Power Generation Equipment Overview, Cost, and Installation

Table 23b. Location of On-site Power Generation Infrastructure

Table 23c. Ownership and Anticipated Users of On-Site Power Generation Infrastructure

Table 23d. BABA Compliance

Type of energy generation

Manufacturer of On-site Power Generation

Model of On-site Power Generation

Manufacture Year of On-site Power Generation

Generation Capacity of the system (please indicate kW or MW)

Equipment Cost only Per Power Generation System

Total EPA Funds Expended Per Power Generation System

Total Funds Expended Installation Cost

Total EPA Funds Expended Installation Cost

Total Funds Expended Equipment and Installation

Total EPA Funds Expended Equipment and Installation

Date(s) On-Site Power Generation Equipment was Manufactured

Date the On-site Power Generation was Installation (mm/dd/yyyy)

Date the On-site Power Generation was Operational (mm/dd/yyyy)

State

County

City

Zip Code

Street Adress

Who owns the equipment?

Anticipated Users of On-Site Power Generation Infrastructure

If serving school districts, Name of the School District(s) the On-site Power Generation will serve

If serving school districts, NCES ID of School District that the On-site Power Generation will serve

Is a waiver being used to fulfill BABA compliance for the On-site Power Generation?

Example On-site Power Generation

Solar

Manufacturer Name

Model Name

2023

15 kW

$45,000.00

$45,000.00

$7,000.00

$5,000.00

$52,000.00

$50,000.00

equipment: 3/2024; housing: 6/2023

6/28/2024

7/28/2024

VA

Arlington County

Alexandria

22305

400 1st Street

Walton School District

Walton School District & NoVA Community College

Walton School District

1234567

No - Infrastructure meets all BABA requirements

On-site Power Generation 1

$-

$-

On-site Power Generation 2

$-

$-

On-site Power Generation 3

$-

$-

On-site Power Generation 4

$-

$-

On-site Power Generation 5

$-

$-

On-site Power Generation 6

$-

$-

On-site Power Generation 7

$-

$-

On-site Power Generation 8

$-

$-

On-site Power Generation 9

$-

$-

On-site Power Generation 10

$-

$-

Table 23. Battery Energy Storage System (BESS) Equipment Information

Table 23a. Battery Energy Storage System (BESS) Equipment Overview, Cost, and Installation

Table 23b. Location of BESS Infrastructure

Table 23c. Ownership and Anticipated Users of BESS Infrastructure

Table 23d. BABA Compliance

Type of Battery

Manufacturer of BESS

Model of BESS

Manufacture Year of BESS

Energy Capacity (please indicate kWh or MWh)

Equipment Cost only Per Unit:

Total Federal Funds Expended Per Unit

Total Funds Expended Installation Cost

Total Federal Funds Expended Installation Cost:

Total Funds Expended Equipment and Installation

Total EPA Funds Expended Equipment and Installation

Date(s) BESS and related Equipment was Manufactured

Date of BESS Installation (mm/dd/yyyy)

Date BESS Operational (mm/dd/yyyy)

State

County

City

Zip Code

Street Adress

Who owns the equipment?

Anticipated Users of BESS

If serving school districts, Name of the School District the BESS will serve

If serving school districts, NCES ID of School District that the BESS will serve

Is a waiver being used to fulfill BABA compliance for the BESS?

BESS Example

Lithium-Ion

Manufacturer Name

Model Name

2023

36kWh

$48,000

$20,000

$12,000

$10,000

$60,000.00

$30,000.00

battery: 3/2024; housing: 6/2023

6/28/2024

7/28/2024

VA

Arlington County

Alexandria

22305

400 1st Street

Walton School District

Walton School District & NoVA Community College

Walton School District

1234567

No - Infrastructure meets all BABA requirements

BESS Group 1

$-

$-

BESS Group 2

$-

$-

BESS Group 3

$-

$-

BESS Group 4

$-

$-

BESS Group 5

$-

$-

BESS Group 6

$-

$-

BESS Group 7

$-

$-

BESS Group 8

$-

$-

BESS Group 9

$-

$-

BESS Group 10

$-

$-

Are there any other infrastructure projects associated with this grant that are not listed above?

If no, please leave this section blank. If yes, please provide details in the box below on the infrastructure project and describe how BABA compliance was determined.

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Sheet 11: 11. Final Report

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Final Report: Financial and Narrative Summary

Grant Recipient

Federal Project Award Amount

$-

Total Mandatory Cost Share Amount

$-

Grant Number

Total Project Costs (Fed. + Cost Share)

$-

Federal (EPA) Funds Expended to Date

$-

Project Title

Federal (EPA) Funds Remaining

$-

Table 24. Project Updates - Narrative Responses

Record final project information.

Please paste the planned activities, outputs, and outcome from the last quarterly report. Please indicate the final results below.

Activities

Anticipated Outputs

Anticipated Outcomes

ACTUAL Results

Table 25: Additional Questions

Please provide programmatic and narrative financial results on the project.

Question

Answer

1. Provide a narrative description of the project.

2. Explain the reason for any differences in proposed versus actual outputs/outcomes identified in Table 15 above.

3. Provide a narrative discussion of the actual project results (outputs and outcomes) and how the results are quantified. These may include, but are not limited to:  Number of replaced vehicles;  Dissemination of the project information and increased knowledge via list serves, websites, journals, and press/outreach events (provide web links where applicable);  Widespread adoption of the implemented technology;  Increased public awareness of project and results  Other

4. Provide information on subrecipients and vendors:  Sub-recipient information (name, award amount, project description);  Vendor information (name, payment amount, good/services provided);

5. Provide a narrative discussion of the successes and lessons learned for the entire project.

6. If any cost-share or additional leveraged funds are reported, identify the source of the funds.

7. Was any program income generated during the project period? Identify amount of program income, how it was generated, and how the program income was used.

8. For projects involving vehicle replacement, please provide: a) Evidence that the replacement activity is an “early replacement,” and would not have occurred during the project period through normal attrition (i.e. without the financial assistance provided by EPA). Supporting evidence can include verification that the vehicles replaced had useful life left and fleet characterization showing fleet age ranges and average turnover rates per the vehicle or fleet owner’s budget plan, operating plan, standard procedures, or retirement schedule; and b) Evidence of appropriate scrappage, sale, or vehicle donation (if applicable) including the engine serial number and/or the vehicle identification number (VIN). *Include Attachments as Necessary

9. For projects that take place in an area affected by, or that include affected vehicles affected by, Federal, State or local law mandating emissions reductions, provide evidence that emission reductions funded with EPA funds were implemented prior to the effective date of the mandate and/or are in excess of (above and beyond) those required by the applicable mandate. *Include Attachments as Necessary

10. Did you include at least one photo of successful, new vehicle(s) employed? If yes, please indicate if you approve of permission for EPA's future use of the photo(s) in future internal and external documents including, but not limited to Reports to Congress and case studies highlighting CHDV success stories.

11. Do you have any other comments or feedback?

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Sheet 12: 12. Data Dictionary

Fleet Description Data Fields: Please refer to the following data field dictionary for support in completing tabs 2, 9, and 10
2. PROPOSED WORK PLAN
School District Summary
Prioritized		Select yes if the school district listed on the 2024 CHDV Prioritized School District List.
Self-Certified as Prioritized		If the school district self-certifies as Prioritized, indicate which of the three criteria the school district is using to self-certify.
Non-Attainment Area		Select yes if grantee's vehicles operate in a non-attainment area.
9. FLEET DESCRIPTION
Current Vehicle Information
Basic Vehicle Information
Vehicle Identification Number		Enter the VIN number for each vehicle.
Vehicle Manufacturer		Enter the manufacturer of the existing vehicle.
Vehicle Model		Enter the model of the existing vehicle.
Baseline Vehicle Model Year		Enter the model year of the existing vehicle.
Baseline Engine Fuel Type		Select the type of fuel that is currently being used (prior to upgrade).
Engine Family Name		Enter the Engine Family name of the existing Engine. NOTE: unregulated engines will not have an Engine Family Name. If unregulated, then enter "N/A."
GVWR		Enter the gross vehicle weight rating (GVWR) of the existing vehicle.
Class		Select the class size from the dropdown menu. Note, class size is based on the vehicle's GVWR.
Odometer		Enter the existing vehicle's current odometer reading, in miles.
Annual Miles Traveled		Enter the average number of vehicle miles traveled per year per vehicle.
Annual Idling Hours		Enter the average number of hours the vehicle idles per year.
Annual Amount of Fuel Used		Enter the amount of fuel used in gallons/year.
Remaining Life of Baseline Vehicle		Enter the remaining life of baseline engine/vehicle in years at the time of the upgrade action.
Vehicle Disposition/Replacement Process		Select a vehicle disposition option. Please see Section III.D of the Notice of Funding Opportunity for disposition requirements by existing bus model year.
Did the applicant request a scrappage waiver?		Select the outcome of a scrappage waiver request if applicable.
Basic Fleet Information
Current Fleet Owner		Enter the first and last name and email address of the individual or organization that owns the fleet.
Place of Performance: School District		Enter the name of the school district in which the bus to be scrapped, sold, or donated has operated in.
Place of Performance: NCES ID		Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the bus to be scrapped, sold, or donated has operated in. If you are unsure of the district's NCES ID, you can search for the district at https://nces.ed.gov/ccd/districtsearch/.
Place of Performance: State		Select the two letter postal code for the state in which the bus to be scrapped, sold, or donated has operated in.
Place of Performance: County(s)		Enter the county in which the bus to be scrapped, sold, or donated has operated. If it has operated in multiple counties, record all and separate using a colon (e.g., Polk: Butler).
Place of Performance: City		Enter the city in which the bus to be scrapped, sold, or donated has operated in.
Percentage of Time operated in each County		Enter the percent of time the bus to be scrapped, sold, or donated has operated in each county. If there is more than one. separate using a colon (Polk - 80%: Butler 20%).
New Replacement Vehicle Information
Upgrade Vehicle Information
Year of Upgrade Action		Enter the year the upgrade happened.
VIN for New Vehicle(s)		Enter the vehicle identification numbers (VIN) of the new vehicle.
New Vehicle Manufacturer		Enter the manufacturer of the new vehicle.
New Vehicle Model		Enter the model of the new vehicle.
New Vehicle Model Year		Enter the model year of the new vehicle.
New Engine Family Name		Enter the engine family name of the new vehicle.
New Vehicle Fuel Type		Select the fuel type of the new vehicle.
New Vehicle GVWR		Enter the gross vehicle weight rating (GVWR) of the new vehicle.
Upgrade Cost per Bus		Enter the cost of vehicle in dollars per unit.
Total Federal Funds Expended Per Vehicle		Enter the federal funds expended per vehicle in dollars per unit.
New Vehicle Annual Data
New Vehicle Annual Miles Traveled		Enter the average number of vehicle miles traveled per year per new vehicle.
New Vehicle Equipped with Auxiliary Heater?		Select yes or no to specify whether the vehicle is equipped with an auxiliary heater.
Auxiliary Heater Type		If bus has an auxiliary heater, enter the type.
Zero Emission Vehicle Data
Capable of Bidirectional Charging?		Select yes or no into the cell to specify whether the vehicle is capable of bidirectional charging.
Estimate Range in Miles		Enter the estimated range in miles for the zero-emission vehicle.
Battery Capacity in kWh		Enter the battery capacity in kilowatt-hours for the zero-emission vehicle.
Is the Battery Warranty Included?		Select yes or no into the cell to specify whether the vehicle battery warranty is included.
Number of Years Covered by Battery Warranty		If the battery includes a warranty, indicate the number of years the coverage is valid for
Number of Miles Covered by Battery Warranty		If the battery includes a warranty, indicate the number of miles the coverage is valid for
Total kWh of Battery Discharge Covered by Warranty		Enter the total kWh of battery discharge
Powertrain Warranty Included?		Select yes or no into the cell to specify whether a powertrain battery warranty is included.
Number of Years Covered by Powertrain Warranty		If the powertrain includes a warranty, indicate the number of years the coverage is valid for
Number of Miles Covered by Powertrain Warranty		If the powertrain includes a warranty, indicate the number of miles the coverage is valid for
Is the bus equipped with Telematics?		Select yes or no into the cells it specify whether the vehicle is equipped with telematics.
EPA or its partners may contact me about participating in research opportunities to provide bus or EVSE data that could inform future transportation work.		Select yes or no.
If Yes, Telematics Primary Point of contact (Name and email)		Enter First and Last name and email address.
New Vehicle Fleet Information
New Vehicle Fleet Owner		Enter the first and last name and email address of the individual or organization that owns the fleet.
Does this vehicle operate in multiple counties within the project?		Select yes or no.
Place of Performance Replacement: School District		Enter the name of the school district in which the new bus will operate in. If it will operate in multiple school districts, list all and separate with a colon (e.g., Hampton School District: Edgewood School District).
Place of Performance Replacement: NCES ID		Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the new bus will operate in. If it will operate in multiple school districts, list all NCES IDs and separate with a colon (e.g., 1234567: 7654321).
Does this vehicle operate in multiple counties?		Select yes or no.
% of Time Replacement operated in each County		Enter the percent of time the new bus will operate in each county. If there is more than one, separate using a colon (Polk 80%: Butler 20%)
10. EV INFRASTRUCTURE
EVSE Equipment Information
Type of Charger		Enter the type of charger, either Level 2 (AC charging up to 19.2 kW) or DC Fast Charging.
If Level 2, is it ENERGY STAR certified		Confirm and select yes if applicable. Please see https://www.energystar.gov/
EVSE Manufacturer		Enter the manufacturer of the charging equipment
EVSE Model		Enter the model name of the charging equipment.
EVSE Manufacture Year		Enter the year the charging equipment was manufactured.
Is the EVSE BABA Compliant?		Select an option. EVSE manufactured on or after July 1, 2024 must be meet BABA requirements.
EVSE Maximum Output Power (kW)		Enter the maximum power output of the charging equipment, measured in kilowatts.
Number of Plugs on EVSE		Enter the number of plugs installed on each unit of the charging equipment.
Is the EVSE Capable of Bidirectional Charging?		Select yes or no into the cell to specify whether the charging equipment is capable of bidirectional charging.
Will the Bus and EVSE be Used for V2G?		Select yes or no into the cell to specify whether the buses and charging equipment will be used for vehicle-to-grid (V2G) services.
EVSE Number of Units		Enter the quantity of charging equipment unit
EVSE Equipment Cost only Per Unit:		Enter the cost of the charging equipment per unit.
Total Federal Funds Expended Per EVSE Unit		Enter the total Federal funds expend for charging equipment per unit.
Total Federal Funds Expended for EVSE		No action - autopopulated
Date of EVSE Installation (mm/dd/yyyy)		Enter the date on which the EVSE is permanently affixed.
Location of EV Infrastructure
State		Select the two letter postal code for the state in which the charging equipment will be located.
County		Enter the county in which the charging equipment will be located.
City		Enter the city in which the charging equipment will be located.
Zip Code		Enter the zip code in which the charging equipment will be located.
Street Adress		Enter the street address in which the charging equipment will be located.
Who owns the charger?		Enter the name of the school district or organization that owns the charging equipment.
Does the EVSE serve multiple school districts within this application?		Select yes or no
Name of the School District(s) the EVSE will serve (use a colon between school districts)		Enter the name of the school district in which the EVSE will serve. If it will serve multiple school districts, list all and separate with a colon (e.g., Hampton School District: Edgewood School District).
NCES ID of School District that the EVSE will serve (use a colon between school districts)		Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the EVSE will serve. If it will serve multiple school districts, list all NCES IDs and separate with a colon (e.g., 1234567: 7654321).
Infrastructure Installation Information
Total Funds Expended Installation Cost		Enter the total installation costs for the charging equipment for the EV infrastructure group column.
Total Federal Funds Expended Installation Cost		Enter the total Federal funds expended for installation costs for the charging equipment for the EV infrastructure group column.
Does the Infrastructure Equipment Cost Include Installation?		Please enter yes or no into the cell to specify whether the indicated cost of the charging equipment above includes any installation expenses.
Description of Installation Work		Enter a description of the work performed to install the charging equipment, such as design and engineering, trenching, wiring and electrical upgrades, labor, and permitting.
Installation Work Performed By		Enter the name(s) of the organization(s) that performed the installation work described above.
Installation was conducted by an individual who meets the infrastructure electrician requirements as outlined in the program guidance?		Select electrician category
Is waiver being used to fulfill BABA compliance for the Infrastructure Project		If a waiver is being used to meet BABA compliance requirements, select the waiver type
Total Federal Funds Expended Equipment and Installation		Automated cell that will calculate the total Federal Funds expended for the charging equipment and installation for an EV Infrastructure Group.
On-Site Power Generation Equipment Information
Type of energy generation		Select a type of energy generation, solar or wind.
Generation Capacity of the system		Enter the generation capacity of the system as either kW or MW. Please indicate unit of measurement.
Battery Energy Storage System (BESS) Equipment Information
Type of Battery		Select a type of battery
Energy Capacity		Enter the generation capacity of the system as either kWh or MWh. Please indicate unit of measurment.